The Scapula and Impingement/Rotator Cuff Disease and Treatment

Abstract

Scapular dyskinesis is present in most shoulder injuries (68–100%) [1]. Major progress has occurred in our understanding of scapular dyskinesis. Scapular dyskinesis is now identified around the world and the implications are broad. Our understanding of the scapula now extends far beyond our rudimentary basis of “scapular winging” and neurologic conditions. We can now begin to explore the impact of the scapula on other conditions and explore a more cause and effect relationship. The scapula establishes a platform for effective rotator cuff function and normal shoulder motion. Alterations in scapular motion can be associated with multiple pathologic conditions including rotator cuff weakness and rotator cuff pathology [2]. Clinical data and experimental model systems, including cadaveric and animal models, have also been developed to assess the role of the scapula in impingement and rotator cuff disease. Currently, there is limited evidence to guide our treatment or prevention of rotator cuff injuries that may be secondary to scapular dyskinesis. A better understanding of the role of the scapula in rotator cuff pathology would help optimize clinical management.